International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes

Response to Kilpatrick, Bloomgarden, and Zimmet

  1. David M. Nathan, MD and
  2. on behalf of the International Expert Committee
  1. From the Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, Massachusetts.
  1. Corresponding author: David M. Nathan, dnathan{at}

We appreciate the comment by Kilpatrick et al. (1) regarding the International Expert Committee report on the diagnosis of diabetes with the A1C assay (2). The Committee considered all of the limitations of the A1C assay for populations in which it is not available or is currently too expensive, as well as for individuals in whom the assay may be misleading. On the basis of these recognized limitations, the Committee emphasized the use of the currently recommended glucose tests and criteria in such populations or individuals. We did not “breeze over” any of the relative advantages or disadvantages of the A1C assay as a means of diagnosis; rather, the …

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  1. doi: 10.2337/dc09-1777 Diabetes Care vol. 32 no. 12 e160